A study of prevalence of depression in patients with multi drug resistant tuberculosis

Introduction: Tuberculosis is a chronic debilitating disease of utmost public health concern in countries like India & remains a leading cause of morbidity & mortality throughout the world.Emergence of Multi drug resistant tuberculosis(MDR-TB) has intensified these features contributing to major psychological distress predisposing the patients to a plethora of mental illnesses especially depression. Aims & objectives: To assess the prevalence of Major Depressive Disorder(MDD) among patients suffering from MDR-TB & relationship of depression with socio-demographic factors. Methodology: This cross sectional analytical study was conducted in a tertiary care hospital in Baroda,India.100 patients,diagnosed with MDR-TB,who had undergone treatment for at least 1 month under Category Four of Revised National Tuberculosis Control Program(RNTCP) were included.Patients were diagnosed with MDD using DSM-5 criteria & severity assessed using Hamilton Rating Scale for depression. Results: 32 patients were diagnosed to have MDD,7 had mild depression,20 had moderate depression & 5 were severely depressed.Risk factors namely Female sex,Nicotine dependence (Overall),Nicotine dependence (in males) & alcohol dependence were found to be significantly associated with MDD.Multivariate analysis showed only marital status & nicotine dependence were associated with MDD. Conclusion: With growing number of patients suffering from MDR-TB,need arises to sensitize treating physicians towards cardinal symptoms of depression in these patients.Early diagnosis & treatment of depression will help both the treating physician & the patient in maintaining compliance,improving prognosis & improving the quality of life.